MedPAC rallies against 75% Rule

The Medicare Payment Advisory Commission and hospital industry groups are trying to derail the 75% Rule, which is making it harder for inpatient rehabilitation facilities to receive higher Medicare funding.

The rule requires by July of next year that three-fourths of a facility's patient's have one of 13 qualifying conditions for the facility to receive higher pay. The 13 diagnoses do not necessarily cover all the people who need intensive rehabilitation, MedPAC said in a recent letter to the Centers for Medicare & Medicaid Services.

Last month, CMS issued a report that endorsed the rule's progress, arguing that the rule is helping funnel beneficiaries to the most appropriate setting. Skilled nursing facilities often receive patients who do not go to IRFs, and as a result benefit from generous Medicare revenues.

See MedPAC's comments at http://www.medpac.gov/documents/061107_IRF_comment_JM.pdf.